Zero restraint policy

Are bed rails a good practice for falls prevention?

24 May 2021

Bed rails appear to reduce the number of falls by residents overall. However, they can also increase the severity of falls when they do occur.

When it comes to fall prevention, using bed rails can often be counterproductive.

Before installing side rails, care should be taken to implement a few principles and adapt to the reality of the patient/resident.

- If the patient/resident requests and is unable to leave the bed without assistance, the bars are not considered a restraint measure

- For unfit patients, staff must act in the best interests of the patient

- The use of bars is not a substitute for qualitative care and cannot be the only action for falls prevention

It is also interesting to consider that the majority of falls occur during transfers. In this sense, bed rails can represent an additional risk.

"In the oncology department, about fifteen years ago, the night was a succession of chemotherapy, hydration and contact with doctors. There was a lot of activity and I was alone. I remember going into this room where the person had wedged themselves into the bars of the bed. Face down and legs tangled. As a carer, we all had a similar experience, that same feeling of helplessness"

Testimony of Jérôme Laurent-Michel, nurse and clinical advisor of Mintt

In some cases, the use of bed rails is prohibited

Caution! Do not use bed rails if :

The person is mobile and independent
The person is able to make the decision and refuses the bed rails
The person is very confused, agitated and mobile enough to climb over bed rails. The use of bed rails is akin to restraint. For more information on this sensitive practice:

See our article "Aiming for zero restraint".